Lonliness Can Kill: Here's What Can We Do About It

Dozens of studies have shown that people who have fulfilling relationships with family, friends and their community are happier, have fewer health problems and live longer. But how can we help those who are lonely and lack genuine connection?

A study done by Cigna with 20,000 U.S. adults found that nearly half report sometimes or always feeling alone (46%) or left out (47%). One in four adults (27%) reported rarely or never feeling as though there are people who really understand them. Over 40% of respondents said that they sometimes or always feel that their relationships are not meaningful and that they are isolated from others. The Cigna study also noted that Generation Z (Gen-Z) adults (born between 1995-2010) are the loneliest generation and they report being in worse health than older generations (1). It is also worth noting that, according to research from Bloomberg, Gen-Z will surpass Millennials by the end of 2020 as the most populous generation, comprising roughly 32% of the global population and currently account for 20% of the U.S. population (2). So, they are the loneliest and largest group of people on the planet today.

It seems that as we are connected to a larger, more diverse circle of people via social media channels and other technology channels, and yet we are the loneliest we have ever been. Yet, interestingly, the same Cigna study found that heavy social media users have a loneliness score (43.5) that is not markedly different from the score of those who never use social media (41.7) suggesting that social media use alone is not a predictor of loneliness (1). It seems that the bigger reason is actually the lack of in-person, face-to-face meaningful interaction

High-tech is no replacement for high-touch connection.

The high level of loneliness is enormously important to address because the lack of human contact has serious physiological consequences. One review article, which examined data from more than 308,000 people, found that lack of strong relationships increased the risk of premature death from all causes by 50% — an effect on mortality risk roughly comparable to smoking up to 15 cigarettes a day, and greater than obesity and physical inactivity (3,4). A relative lack of social ties has also been associated with increased risk of cognitive and functional decline, including depression, dementia and mobility loss (5). Feeling lonely has been shown to increase inflammation and stress hormone levels (both of which have been linked to the most common chronic diseases) (5).

The Roseta Effect, named for the town in Roseta, Pennsylvania, demonstrated how tight social ties within the town had a statistically significant impact on the rates of myocardial infarction. This positive impact regressed once social ties disintegrated (6). In all, these findings are not surprising given that the scientific literature is demonstrating that social isolation (and rejection) can influence the activity of not just a couple of genes but broad sets of hundreds of genes.

Loneliness has become such a public health issue that in the summer of 2018 a multidisciplinary group convened at the Bipartisan Policy Center in Washington, DC, to envision a path forward on decreasing social isolation. The roundtable participants identified four action areas to reverse social isolation including: 1) elevating the issue of social isolation and loneliness to the national level, 2) building on existing resources and infrastructure including social and community-based service programs, 3) addressing social isolation through public policy improvements, and 4) calling for a reform in health care delivery and payment systems (7). These recommendations primarily focused on the elderly population and proposed solutions were grounded in the existing healthcare infrastructure. Given the aforementioned data regarding loneliness in the younger population, this is something that is critical to be addressed now and in new ways across the entire lifespan.

The good news is that there is a growing body of evidence which suggests that intimate, connected, face-to-face, in-person contact is supportive in many ways for a healthy and fulfilling life (5). This kind of social interaction has been shown to be protective for our cardiovascular system (less likely to have heart attacks for example with the Roseta Effect), our immune system (protective in breast cancer survival for example), may protect against dementia, positively impacts how resistant we are to infection and disease, may strengthen our physiologic resilience after trauma, and has even been shown to raise our lifetime IQ level (5, 8-10).

While all the mechanisms involved here are not fully understood, there have been various hypotheses regarding some of what might be going on. It has been suggested that social contact switches on and off the genes that regulate our immune response to cancer and the rate of tumor growth (11). More recently, the emerging field of social human genomics research has been demonstrating that external social conditions, especially our subjective perceptions of those conditions, can influence our most basic internal biological processes—namely, the expression of our genes. This research has begun to identify the specific types of genes that are subject to this kind of social-environmental regulation, which neural and molecular mechanisms facilitate this impact on gene expression, and which genetic polymorphisms dictate individual differences in genomic sensitivity to social context (11,12).

Because of these factors, fostering genuine, in-person connection is a foundational pillar interwoven into every aspect of the Wellness Journey Club. This is done to address the loneliness and disconnection that is currently ubiquitous in our society.

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References

1. Polack, E. New Cigna study reveals loneliness at epidemic levels in America. May 2018. Cigna Newsroom. https://www.cigna.com/newsroom/news-releases/2018/new-cigna-study-reveals-loneliness-at-epidemic-levels-in-america

2. Miller LJ and Lu W. Aug. 20, 2018. Bloomberg news article: https://www.bloomberg.com/news/articles/2018-08-20/gen-z-to-outnumber-millennials-within-a-year-demographic-trends

3. Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. PLoS Med. 2010; 7(7): e1000316. https://doi.org/10.1371/journal.pmed.1000316

4. Berkman LF, Melchior M, Chastang JF et al. Social Integration and Mortality: A Prospective Study of French Employees of Electricity of France–Gas of France: The GAZEL Cohort, Amer Jour Epidemiol. 2004; 159(2): 167–174. https://doi.org/10.1093/aje/kwh020

5. Pinker, S. The Village Effect: How Face-to-face contact can make us healthier and happier. 2014. Penguin Random House Publishers.

6. Egolf B, Lasker J, Wolf S, et al. The Roseto Effect: A 50-year comparison of mortality rates. Amer Jour Pub Health. 1992; 82(8): 1089-1092.

7. First B and Tramuto D. July 27, 2018. The Hill article: Loneliness kills: A new public health crisis (and what we can do about it). https://thehill.com/opinion/healthcare/399123-loneliness-kills-a-new-public-health-crisis-and-what-we-can-do-about-it

8. Cohen S and Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull, 1985; 93(2): 310-357. https://psycnet.apa.org/doiLanding?doi=10.1037%2F0033-2909.98.2.310

9. Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol. 2004; 3(6): 343-53. https://www.thelancet.com/journals/lancet/article/PIIS1474-4422(04)00767-7/fulltext

10. Kroenke CH, Kubzansky LD, Schernhammer ES, et al. Social networks, social support, and survival after breast cancer diagnosis. Journ Clin Oncol. 2006; 24(7): 1105-1111. https://ascopubs.org/doi/10.1200/JCO.2005.04.2846

11. Cole SW, Hawkley LC, Arevalo JM, et al. Social regulation of gene expression in human leukocytes. Genome Biol. 2007; 8(9): R189. https://genomebiology.biomedcentral.com/articles/10.1186/gb-2007-8-9-r189

12. Slavich GM and Cole SW. The emerging field of human social genomics. Clin Psychol Sci. 2013 July; 1(3): 331-348.